Advanced

Subclinical atherosclerosis in patients with cyanotic congenital heart disease

Tarp, Julie Bjerre; Sørgaard, Mathias Holm; Christoffersen, Christina; Jensen, Annette Schophuus; Sillesen, Henrik; Celermajer, David; Eriksson, Peter; Estensen, Mette Elise; Nagy, Edit and Holstein-Rathlou, Niels Henrik, et al. (2019) In International Journal of Cardiology 277. p.97-103
Abstract

Introduction: Survival in patients with cyanotic congenital heart disease (CCHD) has improved dramatically. The result is an ageing population with risk of acquired heart disease. Previous small uncontrolled studies suggested that these patients are protected against the development of atherosclerosis. To test this hypothesis, we sought to determine the prevalence of subclinical atherosclerosis in a larger population of patients with CCHD. Method: We compared the prevalence of subclinical atherosclerosis in adult CCHD patients from Denmark, Sweden, Norway and Australia, with that in age-, sex-, smoking status-, and body mass index matched controls. Coronary artery atherosclerosis was assessed on computed tomography with coronary artery... (More)

Introduction: Survival in patients with cyanotic congenital heart disease (CCHD) has improved dramatically. The result is an ageing population with risk of acquired heart disease. Previous small uncontrolled studies suggested that these patients are protected against the development of atherosclerosis. To test this hypothesis, we sought to determine the prevalence of subclinical atherosclerosis in a larger population of patients with CCHD. Method: We compared the prevalence of subclinical atherosclerosis in adult CCHD patients from Denmark, Sweden, Norway and Australia, with that in age-, sex-, smoking status-, and body mass index matched controls. Coronary artery atherosclerosis was assessed on computed tomography with coronary artery calcification (CAC) score. Subclinical atherosclerosis was defined by CAC-score > 0. Carotid artery atherosclerosis was evaluated using ultrasound by measuring carotid plaque thickness (cPT-max) and carotid intima media thickness (CIMT). Lipid status was evaluated as an important atherosclerotic risk factor. Results: Seventy-four patients with CCHD (57% women, median age 49.5 years) and 74 matched controls (57% women, median age 50.0 years) were included. There were no differences between the groups in: CAC-score > 0 (21% vs. 19%, respectively; p = 0.8), carotid plaques (19% vs. 9%, respectively; p = 0.1), cPT-max (2.3 mm vs. 2.8 mm, respectively; p = 0.1) or CIMT (0.61 mm vs. 0.61 mm, respectively; p = 0.98). And further no significant differences in lipoprotein concentrations measured by ultracentrifugation. Conclusion: Young adults with CCHD have similar cardiovascular risk factor profiles and measures of subclinical atherosclerosis, compared with controls. Given their increasing life expectancies, athero-preventive strategies should be an important part of their clinical management.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Cardiovascular disease, Carotid artery atherosclerosis, Coronary artery atherosclerosis, Coronary artery calcification, Cyanotic congenital heart disease, Hyperlipidemia
in
International Journal of Cardiology
volume
277
pages
97 - 103
publisher
Elsevier
external identifiers
  • scopus:85053317547
ISSN
0167-5273
DOI
10.1016/j.ijcard.2018.08.104
language
English
LU publication?
yes
id
8308e68a-d8a1-4b37-8838-bb18e83a0cb3
date added to LUP
2018-11-13 13:40:57
date last changed
2019-10-15 06:50:10
@article{8308e68a-d8a1-4b37-8838-bb18e83a0cb3,
  abstract     = {<p>Introduction: Survival in patients with cyanotic congenital heart disease (CCHD) has improved dramatically. The result is an ageing population with risk of acquired heart disease. Previous small uncontrolled studies suggested that these patients are protected against the development of atherosclerosis. To test this hypothesis, we sought to determine the prevalence of subclinical atherosclerosis in a larger population of patients with CCHD. Method: We compared the prevalence of subclinical atherosclerosis in adult CCHD patients from Denmark, Sweden, Norway and Australia, with that in age-, sex-, smoking status-, and body mass index matched controls. Coronary artery atherosclerosis was assessed on computed tomography with coronary artery calcification (CAC) score. Subclinical atherosclerosis was defined by CAC-score &gt; 0. Carotid artery atherosclerosis was evaluated using ultrasound by measuring carotid plaque thickness (cPT-max) and carotid intima media thickness (CIMT). Lipid status was evaluated as an important atherosclerotic risk factor. Results: Seventy-four patients with CCHD (57% women, median age 49.5 years) and 74 matched controls (57% women, median age 50.0 years) were included. There were no differences between the groups in: CAC-score &gt; 0 (21% vs. 19%, respectively; p = 0.8), carotid plaques (19% vs. 9%, respectively; p = 0.1), cPT-max (2.3 mm vs. 2.8 mm, respectively; p = 0.1) or CIMT (0.61 mm vs. 0.61 mm, respectively; p = 0.98). And further no significant differences in lipoprotein concentrations measured by ultracentrifugation. Conclusion: Young adults with CCHD have similar cardiovascular risk factor profiles and measures of subclinical atherosclerosis, compared with controls. Given their increasing life expectancies, athero-preventive strategies should be an important part of their clinical management.</p>},
  author       = {Tarp, Julie Bjerre and Sørgaard, Mathias Holm and Christoffersen, Christina and Jensen, Annette Schophuus and Sillesen, Henrik and Celermajer, David and Eriksson, Peter and Estensen, Mette Elise and Nagy, Edit and Holstein-Rathlou, Niels Henrik and Engstrøm, Thomas and Søndergaard, Lars},
  issn         = {0167-5273},
  keyword      = {Cardiovascular disease,Carotid artery atherosclerosis,Coronary artery atherosclerosis,Coronary artery calcification,Cyanotic congenital heart disease,Hyperlipidemia},
  language     = {eng},
  pages        = {97--103},
  publisher    = {Elsevier},
  series       = {International Journal of Cardiology},
  title        = {Subclinical atherosclerosis in patients with cyanotic congenital heart disease},
  url          = {http://dx.doi.org/10.1016/j.ijcard.2018.08.104},
  volume       = {277},
  year         = {2019},
}